TOPLINE:

Bimekizumab showed sustained improvements in International Hidradenitis Suppurativa Severity Score System (IHS4) outcomes in patients with moderate-to-severe hidradenitis suppurativa (HS) over 48 weeks, with a more than 50% reduction in severe disease.

METHODOLOGY:

• Researchers conducted a pooled analysis of two randomised, double-blind, placebo-controlled, multicentre phase 3 trials including 1014 adult patients with moderate-to-severe HS from March 2020 to September 2022.
• Patients were randomly assigned in a 2:2:2:1 ratio to receive bimekizumab 320 mg every 2 weeks through week 48; bimekizumab 320 mg every 4 weeks through week 48; bimekizumab 320 mg every 2 weeks up to week 16, followed by 320 mg every 4 weeks up to week 48; or placebo up to week 16, followed by bimekizumab 320 mg every 2 weeks up to week 48.
• The analysis included a 16-week placebo-controlled initial treatment period, followed by a 32-week maintenance treatment period, with outcomes assessed through week 48.
• Outcomes included changes in IHS4 scores, severity stages (mild: IHS4 score ≤ 3; moderate: IHS4 score, 4-10; and severe: IHS4 score ≥ 11), and dichotomous IHS4-55 (an improvement of at least 55% in IHS4 scores) responses from baseline to weeks 16 and 48.

TAKEAWAY:

• At week 16, patients receiving bimekizumab demonstrated greater mean reductions in IHS4 scores from baseline, ranging from -17.2 for those receiving bimekizumab every 4 weeks to -17.8 for those receiving bimekizumab every 2 weeks vs -6.1 for those receiving placebo.
• By week 48, the mean change in IHS4 scores ranged from -24.3 for patients receiving bimekizumab every 2 weeks to -25.8 for those receiving bimekizumab every 2 weeks followed by every 4 weeks compared to -21.6 for those switching from placebo to bimekizumab after week 16.
• At week 16, IHS4-55 response was achieved by 56.0%-57.0% of patients treated with bimekizumab vs 28.1% of those treated with placebo, increasing to 71.0%-77.4% by week 48 across bimekizumab groups, with those switching from placebo to bimekizumab reaching 76.2% by week 48.
• At week 48, approximately 50% of patients shifted from the severe to mild disease category, and approximately one quarter of all patients achieved an IHS4 score of 0, ranging from 23.7% for those on bimekizumab every 2 weeks followed by every 4 weeks to 26.7% for those on placebo followed by bimekizumab, indicating a complete resolution of abscesses, nodules, and draining tunnels.

IN PRACTICE:

"The promising improvements seen with bimekizumab treatment highlight an opportunity to address the need for effective treatments against draining tunnels," the authors wrote.

SOURCE:

This study was led by Thrasyvoulos Tzellos, MD, European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany. It was published online on February 14, 2026, in the Journal of the European Academy of Dermatology & Venereology.

LIMITATIONS:

The baseline severity distribution was heavily skewed towards severe HS, limiting the generalisability of the findings. The use of IHS4 scores as a prespecified "other" endpoint rather than a primary and/or secondary endpoint in the BE HEARD trials limited the strength of conclusions drawn from these analyses.

DISCLOSURES:

This study was funded by UCB. Five authors reported being employees and shareholders of UCB. Several authors reported receiving consultancy fees, speaker fees, advisory board fees, or grants from UCB and various other sources. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.